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Long-term clinical and molecular remissions in patients with mantle cell lymphoma following high-dose therapy and autologous stem cell transplantation

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Abstract

Long-term clinical and molecular remissions in patients with mantle cell lymphoma (MCL) following high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) have been evaluated in only a few studies. Thirty-six patients with MCL received ASCT in our institution (27 patients undergoing first-line therapy, 8 patients undergoing second-line therapy, and 1 patient undergoing third-line therapy). In the case of long-term remission (≥5 years; n = 8), peripheral blood was tested for minimal residual disease (MRD) by t(11; 14) polymerase chain reaction (PCR) and immunoglobulin heavy-chain (IGH) PCR at the last follow-up. Ten-year overall survival (OS), progression-free survival (PFS), and freedom from progression (FFP) after first-line ASCT were 42 %, 43 %, and 54 %; after second-line ASCT, these were all 0 %. Four-year OS, PFS, and FFP for the first-line cohort were 75 %, 48 %, and 61 %, respectively. Four-year OS, PFS, and FFP after second-line ASCT were 55 %, 30 %, and 30 %, respectively. Treatment-related mortality (3 months after ASCT) was 0 %. The only prognostic factor for OS, PFS, and FFP was treatment line (p = 0.011, p = 0.046, and p = 0.023, respectively). No relapses occurred after 5 years following ASCT. So far, eight patients developed sustained long-term clinical and molecular complete remissions of up to 14.6 years following ASCT in the first treatment line. Sustained long-term clinical and molecular remissions can be achieved following ASCT in the first treatment line and apparently less frequent in the second treatment line.

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Acknowledgments

We would like to thank all the patients who took part in this study. We also thank Mona Temel for contributing to the collection of data and Annett Czekalla for contributing to the statistical evaluations.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Oncology and Hematology, Klinikum Oldenburg, University Clinic, Oldenburg, Germany

    Bernd Metzner, Jochen Casper, Doris Kraemer, Bernd Rosien, Silke Schumann-Binarsch, Ruth Thole & Claus H. Köhne

  2. Blood Transfusion Service German Red Cross, Oldenburg, Germany

    Thomas H. Müller & Wolfgang Gebauer

  3. Department of Internal Medicine III, University of Munich, Grosshadern, Germany

    Martin Dreyling & Eva Hoster

  4. Department of Medicine II, University of Schleswig-Holstein, Kiel, Germany

    Christiane Pott

  5. Klinikum Oldenburg, Universitätsklinik für Onkologie und Hämatologie, Rahel-Straus-Str. 10, D-26133, Oldenburg, Germany

    Bernd Metzner

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  1. Bernd Metzner
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Correspondence to Bernd Metzner.

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Metzner, B., Müller, T.H., Gebauer, W. et al. Long-term clinical and molecular remissions in patients with mantle cell lymphoma following high-dose therapy and autologous stem cell transplantation. Ann Hematol 93, 803–810 (2014). https://doi.org/10.1007/s00277-013-1976-x

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  • DOI: https://doi.org/10.1007/s00277-013-1976-x

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